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Circ-Heart Fail：足部水肿要当心啦！

2016-12-13 haofan MedSci原创

足部水肿
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足部水肿在社区没有临床心血管疾病的成年居民中很普遍，并且将来需要住院的心衰存在相关性。

足部水肿的发生率及其与异常心脏结构/功能、脑钠肽和心力衰竭之间的关系均未有研究报道，尤其是在社区中没有心血管疾病史的成年居民中。最近，心血管领域权威杂志Circ-Heart Fail上发表了一篇研究足部水肿和心衰之间关系的文章。

研究人员从MESA研究中（动脉粥样硬化多种族研究）抽取了5004名进行心脏磁共振成像检查的参与者，4196名有完整数据的参与者被纳入该研究进行分析（3501名参与者进行右心室分析）。研究者采用Logistic回归和Cox比例风险分析来评估在自我报告的足部水肿、需要2个枕头支撑的端坐呼吸、夜间阵发性呼吸困难、左心室和右心室的结构和功能、脑钠肽水平与心衰发生之间的相关性。

当前研究中28%的参与者出现了足部水肿。研究者发现足部水肿与明显的左心室或右心室收缩功能不全（射血分数小于50%）不存在相关性。在调整后的模型中，足部水肿与需要2个枕头支撑的端坐呼吸（比值比为1.66；95%可信区间为1.30–2.12）、夜间阵发性呼吸困难（比值比为1.95；95%可信区间为1.55–2.44）与异常的N末端B型钠尿肽前体水平（是指大于400 pg/ml；比值比为1.80；95%可信区间为1.21–2.68）存在相关性。


平均随访10.2年后，4196名参与者中有184名（4.4%）参与者因诊断心衰而住院。在调整年龄、性别和种族的模型中，足部水肿与因心衰而住院之间存在相关性（风险比为1.44；95%可信区间为1.05 -1.97）。当添加额外的包括合并症、左室射血分数基线和以往心肌梗死等协变量时，该相关性依旧存在（风险比为1.43；95%可信区间为1.02–1.99）。足部水肿与心衰发生之间的相关性随着进一步对N末端B型钠尿肽前体水平进行调整后有所减弱。

由此可见，足部水肿在社区没有临床心血管疾病的成年居民中很普遍，并且将来需要住院的心衰存在相关性。

原始出处：

Joseph Yeboah, et al. Pedal Edema as an Indicator of Early Heart Failure in the Community. Circulation：heart failure. December 6, 2016.

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    2016-12-16 1e10c84am36(暂无匿称)

    文章很好，值得学习

    0

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    2016-12-15 1e10c84am36(暂无匿称)

    受益

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=163288, encodeId=6b43163288b8, content=文章很好，值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:01:21 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163041, encodeId=d36f1630413f, content=受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Dec 15 14:30:28 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333351, encodeId=52551333351ae, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356139, encodeId=45e31356139ca, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562408, encodeId=af69156240868, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162607, encodeId=e94816260efa, content=学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Dec 14 06:12:49 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2016-12-15 小华子

    #水肿#

    0

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    2016-12-15 zhaojie88

    #ART#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=163288, encodeId=6b43163288b8, content=文章很好，值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:01:21 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163041, encodeId=d36f1630413f, content=受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Dec 15 14:30:28 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333351, encodeId=52551333351ae, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356139, encodeId=45e31356139ca, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562408, encodeId=af69156240868, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162607, encodeId=e94816260efa, content=学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Dec 14 06:12:49 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2016-12-15 slcumt

    #HEART#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=163288, encodeId=6b43163288b8, content=文章很好，值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Dec 16 14:01:21 CST 2016, time=2016-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163041, encodeId=d36f1630413f, content=受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Dec 15 14:30:28 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333351, encodeId=52551333351ae, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356139, encodeId=45e31356139ca, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562408, encodeId=af69156240868, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Dec 15 12:46:00 CST 2016, time=2016-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162607, encodeId=e94816260efa, content=学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Dec 14 06:12:49 CST 2016, time=2016-12-14, status=1, ipAttribution=)]
    2016-12-14 半夏微凉

    学习了！谢谢分享！

    0